Individual provider Active NPI

Michael Francis Vollmer

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1053767012
Registry record updated Sep 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-06670 Issued in NC
Practice address
791 Jonestown Rd
Winston Salem, NC 27103-1252
Phone
(336) 716-4551
NPI assigned
May 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-06670 NC Primary

Addresses

Primary practice location

791 Jonestown Rd
Winston Salem, NC 27103-1252

Mailing address

PO Box 602658
Charlotte, NC 28260-2658
Phone (336) 716-2011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161102000761 NC Practitioner - Physician Assistant 9133407794 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Wake Forest University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-06670NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Sep 5, 2016 Accepting new patients

Locations

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

791 Jonestown Rd
Winston Salem, NC 27103

Interoperability endpoints

  • Direct secure messaging: mvollmer2755495@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1053767012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602658",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602658",
            "telephone_number": "336-716-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 JONESTOWN RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271031252",
            "telephone_number": "336-716-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOLLMER",
        "first_name": "MICHAEL",
        "middle_name": "FRANCIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.